Mental Health Essentials in Native Communities: A Guide ...

1 Mental Health Essentials in Native Communities: A Guide for GranteesWhat is Mental Health ? Mental Health is more than the absence of Mental disorders. It is an integral part of Health there is no Health without Mental Health . Mental Health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to contribute to his or her A range of socioeconomic, biological, and environmental factors may affect Mental Health ; however, Mental illnesses affect persons of all ethnicities and socioeconomic statuses. It is important to understand the American Indian and Alaska Native (AI/AN) cultural approach to Mental Health and wellness. Many of these communities view overall Health holistically, often focusing on the restoration of balance during illnesses or life challenges.

2 A History of Trauma There are 573 federally recognized tribes and 65 state-recognized tribes in the United States. After over 500 years of contact with non- Native cultures, the indigenous population in North America has survived many traumas, including disease, war, removal from their Native lands, forced boarding school attendance, and relocation. In the early 20th century, the AI/AN population was 5 percent of the original population estimated at first European Despite this historical trauma, many AI/AN communities have found resiliency by maintaining their traditions, culture, language, and sovereign rights as tribal nations well into the 21st century. However, this resilience has come at a cost. Native Americans suffer from disparities in almost every social indicator that measures individual and community well-being, including Mental Health and wellness.

3 As shown in Table 1 on the next page, the 2013 National Survey on Drug Use and Health found higher incidence of Mental Health -related illness for AI/AN populations when compared to the non- Native , May 2018 This fact sheet was prepared for SAMHSA under contract number HHSS280201300001C with SAMHSA, Department of Health and Human Services (HHS). The views, opinions, and content of this publication are those of the author and do not necessarily reflect the views, opinions, or policies of SAMHSA or Health in Indian CountryFor many tribes, wellness is perceived as a whole-self model that includes Mental , emotional, physical, and spiritual aspects. For a society grounded in family and community, nurturing relationships is very important. Many practices in AI/AN identity and culture are considered integral to Mental Health in Native communities .

4 These practices include respecting and honoring community elders and tribal leaders, as well as varied subsistence activities which promote interdependency with nature. It is important to note, while regional practices and language dialects might be similar, each tribe is unique and caution should be used to avoid 1. Holistic view of a person s overall well-beingPhysicalEmotionalSpiritualMent al* This publication lists non-federal resources to provide additional information to consumers. The views and content in those resources have not been formally approved by HHS. Listing of the resources is not an endorsement by HHS or its Health Myths and FactsThis section reviews the facts behind two myths about Mental : Children do not experience Mental Health : Half of people who experience Mental Health disorders show signs before age 14.

5 Even young children may begin to show warning signs of Mental Health concerns. Early Mental Health support can help a child before problems interfere with other developmental : Personality weakness or character flaws cause Mental Health problems. People with Mental Health problems can snap out of it if they try hard : Circumstances are different for everyone, and many people need help to get better. People with Mental Health problems can get better, and many recover Negative PerceptionsIn some AI/AN communities , adverse views of Mental Health do exist. This may correlate with the level of the individual or involved family members deculturation from traditional belief systems. However, the degree of negative perception varies from tribe to tribe and even within tribes, depending on their own beliefs about Mental and physical tribal communities return to using traditional healers, ceremony, and ritual, some AI/AN individuals who experience Mental Health issues are more willing to seek traditional strategies to help with depression, anxiety, and substance use disorders than other types of treatment.

6 As shown in Table 2, the Native worldview of Health and wellness varies in many ways from that of the majority culture in the United the Tribal TTA CenterThe Tribal Training and Technical Assistance (TTA) Center is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). The Tribal TTA Center uses a culturally relevant, holistic approach to deliver TTA on Mental and substance use disorders, suicide prevention, and Mental Health promotion. TTA is offered to a broad audience of all tribal communities , a focused audience of SAMHSA tribal grantees, and an intensive audience of selected AI/AN tribes per World Health Organization. (2016). Mental Health : Strengthening Our Response. Retrieved from Office of the Surgeon General, Center for Mental Health Services, National Institute of Mental Health .

7 (2001). Chapter 4 Mental Health care for American Indians and Alaska natives . Mental Health : Culture, Race, and Ethnicity: A Supplement to Mental Health : A Report of the Surgeon General. Retrieved from SAMHSA. (2014). National Survey on Drug Use and Health 2013. Retrieved from (2017). Mental Health Myths and Facts. Retrieved from See footnote 46 Taylor & Francis. (2005). Stigma of Mental illness among American Indian and Alaska Native Nations: Historical and contemporary perspectives. Issues in Mental Health Nursing, 26, 1,001 1,024 See footnote 6To receive more information about the Tribal TTA Center or to submit a TA request, call (301) 257-2967 or visit 1. 2013 Mental Health AI/AN and the general populations3 Mental Health Mental Health Illness (AMI) (past year)18+ Mental Health illness (SMI) (past year)18+ depressive episode (past year)18+ Health service utilization (past year)18+ thoughts18+ AMI-substance use disorder18+ SMI-substance use disorder18+ 2.

8 Worldview differences that impact Mental Health care7AI/ANMajority CultureRelational/circularLinear, point A to point BMind, body, spirit/onePsyche is the focusMystical/acceptanceScientific/verif icationCeremonials/ritualsPsychotherapyT ribal connectednessIndividualismSpirituality and balanceOrganized religionsCooperation/sharingCompetition/ winningPatience/respectfulAssertive/forc efulPresent-orientedFuture-orientedHerbs , plants, naturePsychopharmacology